A4657 — Syringe, with or without needle, each
A4657 is a HCPCS Level II code for syringe, with or without needle, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4657 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4657
- Long descriptor
- Syringe, with or without needle, each
- Short descriptor
- Syringe w/wo needle
- Added
- January 1, 2002
- BETOS
- P9B
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to A4657
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4657 is not quite right, the correct code is very often within a few positions of it.
- A4641Radiopharmaceutical, diagnostic, not otherwise classified
- A4642Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
- A4648Tissue marker, implantable, any type, each
- A4649Surgical supply; miscellaneous
- A4650Implantable radiation dosimeter, each
- A4651Calibrated microcapillary tube, each
- A4652Microcapillary tube sealant
- A4653Peritoneal dialysis catheter anchoring device, belt, each
- A4660Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
- A4663Blood pressure cuff only
- A4670Automatic blood pressure monitor
- A4671Disposable cycler set used with cycler dialysis machine, each
- A4672Drainage extension line, sterile, for dialysis, each
- A4673Extension line with easy lock connectors, used with dialysis
- A4674Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz
- A4680Activated carbon filter for hemodialysis, each
Questions about A4657
What is HCPCS code A4657?
A4657 is a HCPCS Level II code for syringe, with or without needle, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4657?
The CMS HCPCS file marks A4657 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A4657 paid under the physician fee schedule?
A4657 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.